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NPI Code Detail

MEDICARE: HEARTLAND FAMILY CHIROPRACTIC, P.A.

MEDICARE: HEARTLAND FAMILY CHIROPRACTIC, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center3280MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1128M9HEOTHERMNBCBS GROUP PIN

General Provider Information

NPI Number : 1841335312
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEARTLAND FAMILY CHIROPRACTIC, P.A.
Provider Business Mailing Address
First Line : 23 NORTH MAIN STREET
Second Line : P.O. BOX 793
City : CLARA CITY
State : MN
Zip : 56222-0793
Country : US
Telephone Number : 320-847-3511
Fax Number : 320-847-3752
Provider Business Practice Location Address
First Line : 23 NORTH MAIN STREET
Second Line :
City : CLARA CITY
State : MN
Zip : 56222-0793
Country : US
Telephone Number : 320-847-3511
Fax Number : 320-847-3752
Authorized Official
Title or Position : PRESIDENT
Name : DR. JONATHAN JAY GRUSSING
Credential : D.C.
Telephone Number : 320-847-3511
Provider Enumeration Date : 02/21/2007
Last Update Date : 08/22/2020

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Directions to “HEARTLAND FAMILY CHIROPRACTIC, P.A. ” Practice Location

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